Nagano Hiroaki, Kishaba Tomoo, Nei Yuichirou, Yamashiro Shin, Takara Hiroaki
Department of Respiratory Medicine, Okinawa Chubu Hospital, Okinawa, Japan.
Department of Radiology, Okinawa Chubu Hospital, Okinawa, Japan.
PLoS One. 2017 Jun 26;12(6):e0179795. doi: 10.1371/journal.pone.0179795. eCollection 2017.
Management of severe central airway obstruction due to advanced cancer is a medical and technical challenge. The impact of airway stenting on the clinical outcome of such patients is unclear.
This single-center, retrospective study evaluated 21 patients who underwent airway stenting for advanced cancer. We examined predictors of the post-stenting mortality, including age, serum albumin, tracheal diameter, smoking, opioid use, respiratory failure, and performance status (PS). We also compared survival according to the PS.
The mean survival period after stenting was 85.2 days. On univariate analysis, age, albumin, PS before airway stenting, respiratory failure, admission route, and PS grade were the candidates as possible predictors of prognosis after the procedure. On multivariate analysis, PS before airway stenting was identified as possible predictor of prognosis after stenting (HR 1.6180, 95% CI 0.969 to 2.7015, p = 0.066). The mean survival period after stenting was significantly longer in the good PS group, compared to the poor PS group (147.8 days vs. 38.2 days,p = 0.0346).
Airway stenting for advanced cancer may be more effective for patients in good general condition than in those with poor performance status.
晚期癌症所致严重中央气道梗阻的管理是一项医学和技术挑战。气道支架置入对此类患者临床结局的影响尚不清楚。
这项单中心回顾性研究评估了21例行气道支架置入治疗晚期癌症的患者。我们检查了支架置入后死亡率的预测因素，包括年龄、血清白蛋白、气管直径、吸烟、阿片类药物使用、呼吸衰竭和体能状态（PS）。我们还根据PS比较了生存率。
支架置入后的平均生存期为85.2天。单因素分析显示，年龄、白蛋白、气道支架置入前的PS、呼吸衰竭、入院途径和PS分级是该手术后可能的预后预测因素。多因素分析显示，气道支架置入前的PS被确定为支架置入后预后的可能预测因素（HR 1.6180，95%CI 0.969至2.7015，p = 0.066）。与PS差的组相比，PS好的组支架置入后的平均生存期显著更长（147.8天对38.2天，p = 0.0346）。
对于一般状况良好的晚期癌症患者，气道支架置入可能比体能状态差的患者更有效。
